Effect of pressure-controlled ventilation-volume guaranteed mode on respiratory mechanics in gynecologic laparoscopic surgery

Abstract

Objective To explore the effects of pressure-controlled ventilation-volume guaranteed(PCV-VG) mode on hemodynamics, blood gas analysis and respiratory mechanics in patients undergoing gynecologic laparoscopic surgery, compared with volume-controlled ventilation(VCV) mode. Methods Forty patients undergoing gynecologic laparoscopic surgery were randomly allocated into 2 groups(n=20): group PCV-VG and group VCV. The HR, MAP were recorded before induction of anesthesia without oxygen inhalation (T0), 10 min after tracheal intubation (T1), 40 min after pneumoperitoneum in trendelenburg position (T2), 5 min after closing pneumoperitoneum in supine position(T3) and 5 min after extubation(T4). PaO2, PaCO2, the peak airway pressure (Ppeak), plateau pressure (Pplat) and thoracic compliance (Cdyn) were measured at T1, T2, T3. Results The PaO2 at T2 was significantly lower than that at T1 and T3 in both groups (P 0.05). There were higher Ppeak and Pplat and lower Cdyn at T2 than those at T1 and T3 in both groups (P 0.05). Conclusions In comparison with VCV, PCV-VG can effectively enhance thoracic compliance, lower the airway peak pressure and plateau pressure, improve arterial oxygenation and gas exchange, and decrease the risk of lung injury after mechanical ventilation in patients undergoing gynecologic laparoscopic surgery. Key words: Volume-controlled ventilation; Pressure-controlled ventilation-volume guaranteed; Gynecologic laparoscopic surgery; Respiratory mechanics